Is it safe to perform fat grafting after mastectomy for breast reconstruction?
Researchers from the University of Texas M.D. Anderson Cancer Center and the University of Michigan’s Department of Breast Radiation Oncology conducted a study to answer that question. Their research assessed the risk of locoregional and systemic recurrence in patients who underwent lipofilling for breast reconstruction.
The authors identified patients who underwent segmental or total mastectomy for breast cancer (719 breasts, or cases) or breast cancer risk reduction or benign disease (305 cancer-free breasts) followed by breast reconstruction with lipofilling as an adjunct or primary procedure between June 1981 and February 2014. They then identified matched patients with breast cancer treated with segmental or total mastectomy followed by reconstruction without lipofilling (670 breasts) as controls. The authors used Kaplan-Meier to estimate probability of locoregional recurrence.
During follow-up times of 60 months for cases, 44 months for controls and 73 months for cancer-free breasts, the authors observed locoregional recurrence in 1.3% of cases (9 of 719 breasts) and 2.4% of controls (16 of 670 breasts). Breast cancer did not develop in any cancer-free breast. The cumulative 5-year locoregional recurrence rates were 1.6% and 4.1% for cases and controls, respectively. Systemic recurrence was seen in 2.4% of cases and 3.6% of controls. The authors found no primary breast cancer in healthy breasts reconstructed with lipofilling.
“With this new important data, plastic surgeons should be more likely to offer fat grafting as a reconstructive option for breast reconstruction, now even in patients who are carriers of the BRCA1/2 gene mutation,” study co-author Steven J. Kronowitz, M.D., tells Cosmetic Surgery Times. “These important new findings will dramatically expand the options for cosmetic breast augmentation using liposuctioned fat only without the need for breast implants.”